Apparatus and methods for positioning and securing anchors

• US 8,257,394 B2
• Filed: 01/14/2005
• Issued: 09/04/2012
• Est. Priority Date: 05/07/2004
• Status: Active Grant

• Current Assignee: USGI Medical, Inc.
• Original Assignee: USGI Medical, Inc.
• Inventors: Saadat, Vahid, Elmer, Marvin C.
• Primary Examiner(s): SEVERSON, RYAN J
• Application Number:
  US11/036,866
• Publication Number:
  US 20050251209A1
• Time in Patent Office: 2,790 Days
• Field of Search: 606/151, 606/153, 606/157, 606/232
• US Class Current: 606/232
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/08 Wound clamps or clips, i.e. not or only partly penetrating the tissue suture bridges A61B17/0466; Devices for bringing together the edges of a wound
• CPC Class Codes: A61B 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/00818 Treatment of the gastro-intestinal system
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0441 the shaft being a rigid coil or spiral
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0446 Means for attaching and blocking the suture in the suture anchor
• CPC Class Codes: A61B 2017/045 snug fit within the anchor
• CPC Class Codes: A61B 2017/0451 Cams or wedges holding the suture by friction
• CPC Class Codes: A61B 2017/0454 : the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0456 : Surface features on the anchor, e.g. ribs increasing friction between the suture and the anchor
• CPC Class Codes: A61B 2017/0458 : Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0459 : Multiple holes in the anchor through which the suture extends and locking the suture when tension is applied
• CPC Class Codes: A61B 2017/0461 : with features cooperating with special features on the suture, e.g. protrusions on the suture
• CPC Class Codes: A61B 2017/0462 : One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/0475 : using sutures having a slip knot
• CPC Class Codes: A61B 2017/0488 : Instruments for applying suture clamps, clips or locks
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/06052 : Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
• CPC Class Codes: A61B 2017/081 : Tissue approximator A61B2017/1103, A61B17/8866 take precedence
• CPC Class Codes: A61B 2017/3488 : Fixation to inner organ or inner body tissue

Abstract

Apparatus and methods for positioning and securing anchors are disclosed herein. The anchors are adapted to be delivered and implanted into or upon tissue, particularly tissue within the gastrointestinal system of a patient. The anchor is adapted to slide uni-directionally over suture such that a tissue plication may be cinched between anchors. A locking mechanism, either within the anchor itself or positioned proximally of the anchor, may allow for the uni-directional translation of the anchor while enabling the anchor to be locked onto the suture if the anchor is pulled, pushed, or otherwise urged in the opposite direction along the suture. This uni-directional anchor locking mechanism facilitates cinching of the tissue plication between the anchors, and it may be utilized in one or several anchors in cinching a tissue fold.

Claims

1. An anchor system for surgical implantation in tissue comprising:

an expandable anchor body adapted for placement against a tissue surface, the anchor body retained on a single suture extending through the anchor body;

a locking mechanism moveable into contact with the anchor body to hold the anchor body into contact with the tissue surface;

the anchor body expandable via the locking mechanism pushing on the anchor body, with the locking mechanism defining a lumen for passage of the single suture through the lumen, wherein the locking mechanism has an interference element movably disposed within the lumen that is configured to contact the single suture, such that the single suture is uni-directionally advanceable through the lumen relative to the anchor body, and wherein the locking mechanism comprises a tubular member having a distal opening, a proximal opening, and a plug or cap attached to the tubular member that substantially covers the proximal opening; and

a delivery device having an interior space with the anchor body and the locking mechanism in the interior space.

2. The anchor system of claim 1, wherein the anchor body comprises a basket anchor.

3. The anchor system of claim 1 with the locking mechanism holding the anchor body in an expanded configuration.

4. The anchor system of claim 1, wherein the lumen defines a profile configured for passage of the suture past the interference element when the anchor body is advanced distally relative to the suture.

5. The anchor system of claim 1, wherein the lumen defines a profile configured to preclude passage of the suture past the interference element when the anchor body is moved proximally relative to the suture.

6. The anchor system of claim 5, wherein the locking mechanism is configured to friction lock or interference fit the suture between the interference element and a wall of the lumen when the anchor body is moved proximally against the locking mechanism.

7. A surgical anchor system comprising:

an anchor body adapted for placement, against a tissue surface, the anchor body retained on a single suture extending through the anchor body;

a locking mechanism in contact with the anchor body, for holding the anchor body into contact with the tissue surfaces;

the anchor body expandable via the locking mechanism pushing on the anchor body;

the single suture extending through a lumen in the locking mechanism;

an interference element movable within the lumen to resist proximal movement of the anchor body along the suture; and

a delivery device including needle having a tissue piercing distal tip, and with the anchor body and the locking mechanism within an interior space of the delivery device.

8. The anchor system claim 7, wherein the anchor body comprises a basket anchor.

9. The anchor system of claim 8, wherein the basket anchor is reconfigurable from a delivery configuration to an expanded configuration.

10. The anchor system of claim 7, wherein the locking mechanism is configured to friction lock or interference fit the suture between the interference element and a wall of the lumen when the anchor body is proximally relative to the suture.

11. The anchor system of claim 7, wherein the locking mechanism lumen is tapered.

12. The anchor system of claim 7, wherein the interference element comprises a ball or sphere.

13. Apparatus comprising:

an anchor assembly including;

a first expandable anchor, a second expandable anchor, and a locking mechanism;

a single suture extending through the first anchor, the second anchor and the locking mechanism;

with, the first anchor in between the locking mechanism and the second anchor, and with the locking mechanism initially moveable relative to the first anchor and in contact with the first anchor after the first anchor is placed at a surgical site within a patient,

the locking mechanism including an interference, element contained within a tube having an inclined interior surface, with the interference element movable into a first position where the suture can move freely through the locking mechanism, when the suture is pulled in a distal, direction, to a second position where the interference element locks against the suture, when the suture is pulled in a proximal direction; and

a delivery device, for delivering the anchor assembly to the surgical site in the patient, the delivery device having a lumen extending through a delivery needle, and with the anchor assembly provided within the lumen and movable out of the lumen and into the surgical site via a pusher.

14. The apparatus of claim 13 with the locking mechanism integral with the first anchor.

15. The apparatus of claim 14 with the first anchor comprising a basket anchor having a collar and the locking mechanism attached to the collar.

16. The apparatus of claim 14 with the locking mechanism attached to the first anchor.

17. A surgical anchor system, comprising:

a delivery device including a needle having a tissue piercing distal tip;

an anchor body adapted for placement against a tissue surface, the anchor body retained on a single suture extending through the anchor body;

a locking mechanism in contact with the anchor body, for holding the anchor body into contact with the tissue surface, and with the single suture extending through a lumen in the locking mechanism;

the locking mechanism and the anchor body within the delivery device;

the anchor body having a plurality of radially expandable resilient arms, with the anchor body reconfigurable from a low profile delivery configuration to a radially expanded deployment configuration, with the arms extending radially outwardly once released from the delivery device, and with the locking mechanism holding the anchor body in the expanded deployment configuration by pushing on the anchor body; and

an interference element movable within the lumen to resist proximal movement of the anchor body along the suture.